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1、·374·ChineseJournalofReparativeandReconstructiveSurgery,April2007,Vol.21,No.4颈椎侧块钛板螺钉内固定治疗颈椎骨折脱位张新何慕舜张展奎李铁峰叶俊强陈伟全左文建欧阳冰曾月东【摘要】目的探讨颈椎侧块钛板螺钉内固定治疗颈椎骨折脱位的手术疗效。方法2001年9月～2006年3月,收治颈椎骨折脱位31例,男24例,女7例;年龄20～63岁。车祸伤25例,高处坠落伤4例,重物砸伤2例。颈椎损伤节段:C31例,C45例,C512例,C610例,C73例;病程1～23d。其中29例合并脊髓神经根损伤,Frankle分级,A
2、级14例,B级3例,C级7例,D级3例,E级2例(合并神经根损伤伴有手、肩麻木),均行脊髓减压、小关节植骨融合、侧块钛板内固定术;另2例无脊髓神经根损伤,仅行小关节植骨和内固定。术后摄X线片观察植骨融合、颈椎活动及内固定稳定情况,并按Frankle分级法评定神经功能恢复情况。结果术后31例均获6个月～4年随访。X线片可见颈椎小关节植骨融合,时间为3～6个月。术后6个月X线片显示内固定牢固稳定,无折断松动等并发症。29例脊髓神经根损伤者中,按Frankel分级,术前A级14例中,术后13例为B级,1例为C级;术前B级3例中,术后为C级2例,D级1例;术前C级7例中,术后D级3例,E
3、级4例;术前D级3例中,术后均为E级;2例E级术后无变化,合并神经根损伤,术后短期内手、肩麻木消失。结论颈椎侧块钛板螺钉为后路短节段固定,最大限度地保留了颈椎的活动度,钛板螺钉固定在颈椎后部的关节柱上,对过伸过屈损伤有良好的稳定作用,是治疗颈椎骨折脱位一种积极有效的方法。【关键词】颈椎骨折脱位后路手术中图分类号:R683.2R687.32文献标识码:ATREATMENTOFLOWERCERVICALFRACTUREDISLOCATIONBYTITANIUMSCREW-PLATEINTERNALFIXATIONONCERVICALLATERALMASSöZHANGXin,HEMus
4、hun,ZHANGZhankui,etal.DepartmentofO2rthopedics,LonggangCenterHospitalofShenzhen,ShenzhenGuangdong,518116,P.R.China.E2mail:yys41@163.comCorrespondingauthor:HEMushun,E2mail:hms5101@163.com【Abstract】ObjectiveToevaluatesurgicalresultsofthetitaniumscrew2plateinternalfixationintreatmentofthelowerce
5、rvicalfracturedislocation.MethodsFromSeptember2001toMarch2006,31patients(24males,7females;agerange,20263years)withthelowercervicalfracturedislocationweretreatedinourdepartment.Theinjurieswerecausedbyaroadaccidentin25patients,ahighcrashin4,andaheavyobjectcrashin2.Thefracturedislocationoccurred
6、inthefollowingcervicalsegments:C3(1patient),C4(5patients),C5(12patients),C6(10patients),andC7(3patients).Thediseasecourserangedfrom1to23days.Theassociatedspinalnerverootinjuryoccurredin29patients.TheFranklescalingrevealedthat14patientswereatGradeA,3atGradeB,7atGradeC,3atGradeD,and2atGradeE(as
7、sociatednerverootinjurywithhandandshouldernumbness).The29patientsunderwentthespinalco2rddecompression,thegraftingfusionofthesmalljoints,andthelateralmasstitaniumscrew2plateinternalfixation;2patientswithoutnerveinjuryunderwentonlythegraftingfu
